North Penn Comprehensive Health Services
Organization Active NPI Federally Qualified Health Center (FQHC) · Laporte, PA
NPI 1093520587 · NPPES record last updated Feb 21, 2025
Key facts
- NPI
- 1093520587
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- NORTH PENN COMPREHENSIVE HEALTH SERVICES
- Practice address
- 217 King St
Laporte, PA 18626 - Phone
- (570) 946-5201
- NPI assigned
- Feb 11, 2025
- Organization subpart
- No
Authorized official
- Name
- Ronald Meryl Gilbert
- Title
- Cfo
- Phone
- (570) 828-3869
Other NPIs on the same Medicare enrollment 14
Other NPIs with the same Medicare PAC ID 13
Corporate family (same tax ID) 13
Practitioners 75
-
Tyler O Benelli, LCSW
-
James Biery, PA-C
-
Daniel Lee Branzburg, FNP-C
-
Kelly S. Carr, CRNP
-
Gerald H Cerrone, PH.D.
-
Brandyn M Choplosky, PA-C
-
Amanda Lynn Cunningham, CRNP
-
Tina Marie Doud-Kearns, FNPC
-
Debra Ann Dresser, PA-C
-
George Reyes Dy, M.D.
-
Beth Anne Geiger, DNP
-
Steven L Heffner, D.C.
-
Tami Hite, NP
-
Alyssa Hoffman, LCSW
-
Quintin Ireland, MD
-
Katryn Keefer, PA-C
-
Elizabeth Marie Koury, PA-C
-
Scott G Kroll, CRNP
-
Kathryne Grace Lutz, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA
Federally qualified health center certification: CCN D31037
- Legal name
- NORTH PENN COMPREHENSIVE HEALTH SERVICES
- Doing business as
- SULLIVAN COUNTY LAUREL HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Apr 4, 2025
- Last certification
- Apr 4, 2025
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 217 King Street
Unit 3
Laporte, PA 18626
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Scott D Myers |
Corporate Director |
Apr 1, 2025 | |
| John Dennis Murray |
Corporate Director | Jul 1, 1986 | |
| Donna R Wilson |
Corporate Officer |
Jun 1, 2013 | |
| Sean Sember |
Corporate Director | Sep 22, 2021 | |
| James a Nobles |
W-2 Managing Employee |
Mar 5, 2018 | |
| Thomas Thompson |
Corporate Officer |
Jul 1, 2022 | |
| Jody Thomas |
Corporate Officer |
Jul 1, 2019 | |
| Megan Wells-Williams |
Corporate Director | Jul 7, 2021 | |
| Kelly Irwin |
Corporate Director | Jul 1, 2023 | |
| Ronald M Gilbert |
W-2 Managing Employee |
Aug 14, 2015 | 100% |
| Kimberly Johns |
Corporate Director | Jun 29, 2022 | |
| Kristopher Kaufman |
Corporate Director | Jul 1, 2022 | |
| Darla Bortz |
Corporate Director |
Apr 1, 2025 | |
| Jason Krise |
Corporate Officer |
Jul 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040416000152 | PA | Part B Supplier - Clinic/Group Practice | 0446245880 |
Receives reassigned benefits from 67 practitioners 14 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mansfield, PA; Westfield, PA; Wellsboro, PA; Troy, PA; Towanda, PA; Blossburg, PA; Elkland, PA; Lawrenceville, PA… |
| O20250602002163 | PA | Part a Provider - Federally Qualified Health Center (FQHC) | 0446245880 | Practice locations: Laporte, PA |
National Provider Directory
- Tax ID family
- North Penn Comp Health
Locations
245 Main St
Blossburg, PA 16912
Phone (570) 538-2174
105 West Ave
Wellsboro, PA 16901
Phone (570) 723-0620
24 Walnut St
Wellsboro, PA 16901
Phone (570) 723-0760
15 Meade St
Ste L4
Wellsboro, PA 16901
Phone (570) 724-5200
1B Main St
Wellsboro, PA 16901
Phone (570) 724-7100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
217 King St
Laporte, PA 18626
Mailing address
40 W Wellsboro St
Mansfield, PA 16933-1411
Phone (570) 662-1945
Other names
- Sullivan County Laurel Health Center
Other providers in Laporte, PA
- Andrea Lynn Jensen
- Laporte Borough Volunteer Fire Comp
- Eric Warren Longenbach
- Kasey Mastellar
- Mental Health Associates of North Central PA
- Northern Tier Counseling, Inc
- Amber Julia Pedro
- Rural Health Corporation of Northeastern Pennsylvania
- Samuel Edwin Schrack
- Sullivan County Action,Inc.
All providers in Laporte, PA · Federally Qualified Health Center (FQHC) in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.